Direct-to-implant reconstruction after mastectomy is routinely performed with excellent oncologic and aesthetic outcomes. Several different techniques for placement of the prosthesis including total and partial subpectoral coverage have been described. Prepectoral implant placement is increasingly reported as a safe method, while patient selection and techniques are areas of further work. Most prepectoral prosthesis placement techniques describe complete acellular dermal matrix (ADM) coverage of the implant, often requiring multiple or larger ADM sheets than a comparable subpectoral implant procedure, resulting in high cost per reconstructed breast. This article describes the use of a vicryl mesh pocket and ADM support in prepectoral breast reconstruction achieving predicable and safe results at a lower cost.
From the Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Mass.
Received for publication January 22, 2018; accepted February 13, 2018.
Published online 9 April 2018.
Disclosure: Dr. Gfrerer has no conflict of interest to disclose. Dr. Liao has consultancy agreements with manufacturers of Alloderm (Allergan, Inc) and FlexHD (Musculoskeletal Transplant Foundation). The Article Processing Charge was paid for by the authors.
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Eric C. Liao, MD, PhD, Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, 15 Parkman Street, WACC 435, Boston, MA 02114, E-mail: firstname.lastname@example.org
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